<?php
/* @var $this ContactRxRightController */
/* @var $model ContactRxRight */
/* @var $form CActiveForm */
?>

<div class="form">

<?php $form=$this->beginWidget('CActiveForm', array(
	'id'=>'contact-rx-right-form',
	'enableAjaxValidation'=>false,
)); ?>

	<p class="note">Fields with <span class="required">*</span> are required.</p>

	<?php echo $form->errorSummary($model); ?>

	<div class="row">
		<?php echo $form->labelEx($model,'od_bc'); ?>
		<?php echo $form->textField($model,'od_bc',array('size'=>5,'maxlength'=>5)); ?>
		<?php echo $form->error($model,'od_bc'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'od_diameter'); ?>
		<?php echo $form->textField($model,'od_diameter',array('size'=>5,'maxlength'=>5)); ?>
		<?php echo $form->error($model,'od_diameter'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'od_power'); ?>
		<?php echo $form->textField($model,'od_power',array('size'=>5,'maxlength'=>5)); ?>
		<?php echo $form->error($model,'od_power'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'rx_id'); ?>
		<?php echo $form->textField($model,'rx_id'); ?>
		<?php echo $form->error($model,'rx_id'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'personalinfo_id'); ?>
		<?php echo $form->textField($model,'personalinfo_id'); ?>
		<?php echo $form->error($model,'personalinfo_id'); ?>
	</div>

	<div class="row buttons">
		<?php echo CHtml::submitButton($model->isNewRecord ? 'Create' : 'Save'); ?>
	</div>

<?php $this->endWidget(); ?>

</div><!-- form -->